Exam 1 Flashcards by Brittni Barnes

What are the 3 Categories of Physical Agents?

Thermal
Mechanical
Electromagnetic

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What are examples of Thermal Physical Agents?

Superficial-Heating Agents: Hot Pack
Cooling Agents: Ice Pack (cold pack)
Deep-Heating Agents: Diathermy

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What are examples of Mechanical Physical Agents?

Traction: Mechanical Traction
Compression: Elastic Bandage
Water: Whirlpool
Sound: Ultrasound

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What are examples of Electromagnetic Physical Agents?

Electromagnetic Fields: Ultraviolet

Electric Currents: TENS

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What are the Effects of Physical Agents?

Modify Inflammation and Healing
Relieve Pain
Alter Collagen Extensibility
Modify Muscle Tone

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What are the general Contraindications and Precautions of Physical Agents?

Pregnancy: only if energy produced by the physical agent may reach the fetus
Malignancy: some agents have shown to accelerate growth of cancerous tissues
Pacemaker: may alter the functioning of pacemaker
Impaired sensation: if patient cannot report of how the treatment feels.

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What are the Common Causes of Inflammation?

Soft tissue trauma (sprain, strain, contusions)
Fractures
Foreign bodies (sutures)
Autoimmune disease (RA)
Chemical agents (acid)
Thermal agents (burns, frostbite)
Irradiation (UV)

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What are the 3 Phases of Inflammation?

Inflammation Phase
Proliferation Phase
Maturation Phase

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Describe Inflammation Phase & time frame

Prepares wound for healing

*Days 1-6

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Describe Proliferation Phase & time frame

Rebuilds the damaged structures and straightens the wound

*Days 3-20

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Descrive Maturation Phase & time frame

Modifies the scar tissue into its mature form

*Day 9-on

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What are the 5 Cardinal Signs of the Inflammation Phase?

Color=Heat
Rubor=Redness
Tumor=Swelling
Dolor=Pain
Functio Laesa=Loss of function

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What are the 2 Categories of Factors Affecting the Healing Process and examples under each?

Local Factors

Type, size, location of injury
Infection
Vascular supply
External forces
Movement

Systemic Factors

Age
Disease
Medications
Nutrition

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Is the healing of Skeletal muscle regeneration well documented?

NO, not a lot of evidence behind it

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What are the stages of Fracture Healing?

Impaction
Induction
Inflammation
Soft Callus formation
Hard Callus formation
Remodeling

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What are the 4 types of response in the Inflammation Phase?

Vascular: vasoconstriction to minimize blood loss
Hemostatic: platelets enter site and fibrin to stimulate clotting
Cellular: macrophages is most important cell and essential to wound healing
Immune

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What happens in the Proliferative Phase?

Reestablish the epidermis
Collagen production
Wound contraction

What happens in the Maturation Phase?

Can last for over a year
Ultimate goal is to restore to prior function of injured tissue
Keloid or Hypertrophic scar

What are the Types of Pain?

Acute
Chronic
Referred

Define Acute Pain

Pain of less than 6 months duration with no underlying pathology

Define Chronic Pain

Pain that does not resolve in the usual time it take for the disorder to heal OR that continues longer than noxious stimulation

Define Referred Pain

Pain felt at a location distant from the actual source of pain

How is pain transported to the brain?

Stimulus transmitted along peripheral nerves to CNS from where it can reach cortex and consciousness

What are A-delta Fibers and what % are they?

They are small myelinated fibers that transmit more quickly and make up 20% of pain-transmitting fibers

High intensity
Sharp, stabbing or pricking
Quick onset but short lasting

What are C Fibers and what % are they?

They are small un-myelainated fibers that transmit action potentials slowly and make up 80% of pain-transmitting fibers - Dull, throbbing, aching, burning - long lasting

Who first proposed The Gate Control Theory? when?

Melzack and Wall in 1965

What is an examples of a Nonnociceptive Sensory Receptor?

- Touching injury - Heat pack - Cold pack

What is the general theory of the Gate Control Theory?

Increased activity of nonnociceptor (pain receptors) causes inhibition of T cells (make local connection with spinal cord) which causes a closing of the gate to brain and decreases sensation of pain.

What are 2 ways of measuring pain?

- Visual Analog Scale: asses pain by asking patient to indicate present level of pain on a drawn line - Numeric Rating Scale: rate pain numerically on a scale of 1-10 or 1-100

What are the limitations of the Pain Scales?

Fail to provide information about how the pain is impacting the patients functional activity level.

What are the goals of Pain Management?

- Eliminating the cause of pain - Control nociceptor input - Reduce degree of patients impairment

What are different approaches to Pain Management?

- NSAIDs: anti-inflammatory - Acetaminophen (Tylenol): good for patients with GI problems - Opiates: narcotic drugs for patients that have pain that is not controlled by non-narcotics - Antidepressants: treatment of depression - Spinal Analgesia: medications injected into space of spinal cord - Local Injection: corticosteroid for local injection for short term pain relief - Physical Agents

Define Muscle Tone

The muscle tension at rest

Define Flaccidity

Lack of tone or zero resistance (total paralysis of muscle)

Define Hypotonicity

Decreased resistance to stretch

Define Hypertonicity

High tone

Define Spasticity

Unusual tightness or stiffness or pull of muscles

How do you measure spasticity muscle tone?

Pendulum Test or EMG

How do you measure muscle tone?

``` Normal Tone 2+ No Tone 0 Hypotonia 1+ Moderate Hypertonia 3+ Severe Hypertonia 4+ ``` Reflexes: tapping on tendon

What are the anatomical bases for muscle tone and activation?

- contractile elements in muscle fiber - cellular elements providing structure - connective tissue - tendons - passive and active elements - myofilaments - heat and cold

What is treatment for low tone?

Things to active and wake up the muscle

How do you treat high tone?

You want to calm down the muscle and relax it